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Updated: Apr 20, 2026
The Intra-Aortic Balloon Pump
Published on: February 5, 2021
Intra-aortic balloon pump in coronary artery bypass graft - factors affecting outcome
Ke Okonta1, M Anbarasu1, K Kanagarajan2
1Department of Cardiac Surgery Institute of Cardiovascular Diseases Madras Medical Mission, Chennai, India.
Insights
Early use of intra-aortic balloon pump (IABP) in high-risk coronary artery bypass graft (CABG) patients improves outcomes. IABP reduces intensive care unit (ICU) stay and mortality, with elevated creatinine indicating higher risk.
Area of Science:
- Cardiology
- Cardiac Surgery
- Critical Care Medicine
Background:
- Management of high-risk coronary artery bypass graft (CABG) patients presents challenges, particularly concerning postoperative low cardiac output states.
- Perioperative inotropes can be detrimental, highlighting the need for mechanical circulatory support like the intra-aortic balloon pump (IABP).
Purpose of the Study:
- To evaluate the efficacy of intra-aortic balloon pump (IABP) in coronary artery bypass graft (CABG) patients.
- To analyze factors influencing morbidity and mortality associated with preoperative and postoperative IABP use in CABG patients.
Main Methods:
- A retrospective study of 3974 CABG patients between March 2007 and February 2011.
- Analysis of 107 patients (2.7%) who received IABP, examining demographic data, clinical features, indications, management, and outcomes.
- Statistical analysis included means, standard deviations, and Pearson's Chi-square test (p<0.005).
Main Results:
- IABP was inserted preoperatively in 55.1% and postoperatively in 44.9% of patients.
- Mortality was 15.0% for preoperative IABP insertion versus 29.0% for postoperative insertion (p=0.005).
- Preoperative IABP insertion was associated with longer ICU stay (8.3 days) compared to postoperative (5.7 days), but lower overall mortality (16.8% vs 27.1%, p=0.005).
Conclusions:
- Early institution of IABP in high-risk CABG patients leads to better outcomes, including reduced ICU stay and mortality.
- Elevated post-insertion creatinine levels serve as an indicator of impending mortality, prompting early intervention protocols.
Background:
The management of coronary artery bypass graft (CABG) patients, especially in high risk patients ,can be challenging as the postoperative periods may be characterized by a low cardiac output state. Inotropes used in the perioperative periods to increase cardiac output may be detrimental thus making the use of mechanical devices like intra-aortic Balloon pump (IABP) for circulatory assistance desirable.
Aims & Objectives:
To study the use of intra-aortic balloon pump in coronary artery bypass patients in preoperative and post operative settings and factors that affect morbidity and mortality.
Setting:
Madras Medical Mission, Chennai, India.
Method:
A retrospective study of 3974 consecutive patients who had CABG done between March 2007 and February 2011 with or without additional procedures. One hundred and seven (2.7%) patients had IABP instituted either pre-operatively or postoperatively when it was obvious the patient will need cardiac assistance. The demographic data, clinical features, the indications for insertion, management offered and outcome , the creatinine levels, the duration of intraarortic balloon pump, the intensive care unit(ICU) and Hospital stay were analyzed for means and standard deviations and Pearsons Chi-square test using SPSS 10.0 window soft ware version with significant value of p-value<0.005.
Result:
The mean age of all the patients was 59.7 + SD 10.7, 85(79.4%) patients were males,22(20.6%) were females .Out of the 107 patient who had IABP insertion, 59(55.1%) patients had IABP inserted preoperatively and 48(44.9%) postoperatively. The creatinine levels after the insertion of IABP in 68 patients was<1.5mg/dl and in 39 patients was>1.5mg/dl with mortality of 15.0% for the preoperative insertion group versus 29.0% for the postoperative group respectively (p=0.005). The preoperative and postoperative insertion ICU stay were 8.3+4.7 days and 5.7+1.6days respectively (p=0.005) and mortality were16.8% and 27.1 %( p=0.005) respectively.
Conclusion:
Early institution of intra-aortic balloon pump gives a better outcome even in high risk coronary artery bypass graft patients as it reduces ICU stay and mortality, and elevated post-insertion creatinine levels has been shown to be an indicator of impending mortality and so an early warning for putting in place mitigating protocols.
